I know that we all wear many hats as we earn a living. For some reason I find it humorous to tell my kids what I have to do by saying things like, “Give me a minute, I need to get my linen guy to move the stuff from the washer to the dryer.” or, “my boss is making me…” I don’t know why, I just get a kick out of it.
This weekend at the breakfast table after making some statement about what I need to do for my “boss” my youngest says to me, “Daaaaaad! You ARE your boss.” I realized that I needed to explain something to him about being self-employed, so I broke things down a little bit for him. I explained that I actually work, not only for the people who climb onto my massage table, but also for those who MIGHT climb onto my table. “You see, I might be ‘self employed,’ but what that really means is that I have a great responsibility to do the right thing by the people whose care is entrusted to me,” I explained to him. I wear all the hats because I am a one-person operation just like many other small business owners. That means I get the praises when things go right and the blame if things do NOT go quite so right. I get to make all the decisions and if it doesn’t work out, I have to correct it. I don’t really think he was ready for that response, but I feel that he needs to realize that I don’t do massage for myself. I know there are others who can care for your health, but my responsibility is to YOU and my family. I know that every time you choose to come see me, you are helping me support them. Thank you for that.
And in that spirit…if y’all think I don’t post enough relevant content, just let me know and I will get after my social media guy. This is because I work for you as well as to help feed and support the ones who sit and eat at that breakfast table where this conversation happened.
I recently watched a stand-up comedy routine by Steve Soelberg that was completely focused on the meaning of “undress to your comfort level” when preparing to receive massage. The comedian explained that his “comfort level” is fully dressed because that is what society has taught him. He went into hilarious detail about the dilemma of interpreting the meaning of this and other massage terms. I laughed so hard that I cried. And then I thought, of course there is some confusion. Most therapists assume that this term is self-explanatory and a lot of people are embarrassed to ask what we mean. So, I will shed some light on what I mean when I say, “undress to your level of comfort.”
As a therapist who has been doing massage since 1999, this is something I say all the time yet rarely am I asked what I mean. The truth is that this is what we are taught to say in massage school, and when I taught massage I told my students the same. Now, in a three and a half hour class there was always time to explain what that means. We would go into great detail on things like how we greet people in a professional way, the importance of informed consent, and how to protect a person’s modesty through proper draping techniques (this is what I call sheet origami). In the class environment understanding is not assumed and there is plenty of time to get to a great variety of comfort levels and how to work within them.
When someone is about to climb on a massage table, however; there is an assumption that clients know what we mean when we talk of comfort levels. There is also an urgency to start the massage that often prevents a lot of questions from our clients. As a result the most important person in the room is sometimes left with this dilemma. “What IS my comfort level?” So, let’s take a look at some things to consider.
Your comfort level is what you are comfortable with. It sounds simple, but in many cases it is anything but simple. I remember my first massage and how I wrestled with this concern. I was at the Utah College of Massage Therapy student clinic on the weekend I enrolled in massage school. I knew that massage therapists were used to working on people who have nothing but a sheet on their bodies, but this was a student who would be working on me. Was this person ready for me to take all of my clothes off? I had read something somewhere in the school’s policies that made me think that she might not expect me to take everything off. So, I didn’t take off my underwear. In the end I found that I misunderstood the policy and I was sad because it clearly got in the way of the work she was doing. She did an amazing job anyway, but it would have been even better if I had removed all of my clothes. As a client I was too timid to ask a question that would have made my decision easier and the massage better. I have not repeated that mistake. For me though, this is easy and an easy conversation to have with another therapist.
Receiving a massage is an intimate experience. I know that may make it sound inappropriate, but I do not mean that in a sexual or inappropriate way. When you schedule a massage appointment you plan to go into a room that is often dimly lit, soft music is likely playing, and a person will be touching you for nearly an hour or hour and a half. Most people are not used to experiencing this kind of focused attention. When we are touched for these long periods of time we must completely trust that the person who is touching us has our best interest at heart. You are literally putting yourself in the hands of another person, that alone can be overwhelming. Now on top of that you may have no clothing on as you lay under a sheet.
When you are on the massage table you bring life experiences with you. This includes things like, your touch history (good and bad), your body image, and your culture of modesty. Each of these categories on its own can provide a lot of concerns. Some people have been through various abuses, or invasive medical procedures. In current society we are becoming more aware of the emotional aspects of our body image and what a real struggle that can be. Many of us feel as if we are constantly being judged for how we look. Modestly is sometimes determined by body image, but the root is often based in on a person’s theological or cultural background. All of these factors and many more affect comfort levels in individual ways. These differences are not always apparent from first impressions. For example, one week I had two women in their late 60’s from the same region of country, each with at least 3 grown children, and many other similar life experiences as far as I could tell. We could expect that they would have similar outlooks when it came to receiving massage, because each had received many massages before they came to me, but that was not the case. One held strongly to her modesty and the other said to me, “Honey please, I have 3 grown children. I am not modest.” In both cases, of course I provided the strict modesty protection I do with everyone. It is our duty as care providers to understand that each person has different concerns and needs, but we also need to set and follow consistent professional boundaries.
Is it ideal for the therapist if a client takes everything off? In many cases, yes. Clothes can inhibit the use of some techniques and limit access to areas of the body that may need attention in order to relieve pain or dysfunction. The hip is an area of the body that typically carries a lot of tension and often affects the lower back. If underwear is in the way it can be difficult to address the cause of these types of back pain. In a similar way, a bra can get in the way of shoulder work that could relieve neck pain and headaches. Also, we can do really nice long flowing strokes that are soothing and show the body how it is connected. Few things are as comforting as a long flowing stroke that starts at at your foot, goes all the way up your leg, around your hip, slowly up your back, over your shoulder and down your arm to your fingertips (now reread this sentence nice and slowly feeling it as you read).
Not fully undressing is okay though, because if a person is lying naked on my table and worried about being vulnerable, that will get in the way of the healing process. When you are not able to relax into the experience and release the pain or discomfort that is the reason for the massage, the entire session can be lost. Wasting your time would be more of a problem for me than working around your clothes. There are a number of different modalities of bodywork that are performed on people who are partially or fully dressed. John Barnes approach to Myofascial Release, Craniosacral Therapy, and Structural Integration are all modalities where the person being treated is partially dressed. Seated massage is performed in a variety of different locations, many of them being public and the person receiving the treatment is typically fully dressed. Now, if you do not want to receive these types of services that is okay too. Massages can, and should be adapted to suit your comfort and needs (now reread this sentence with a firm parental tone).
Your comfort level is where you can surrender to the session and be open to healing. When you receive a massage your comfort level is up to you and no one else. It may even vary over time. Your therapist should meet you in that space of comfort, honoring and working within your boundaries. There are so many different techniques in massage and related bodywork that your therapist should be able to provide the comfort and healing you are looking for, without you worrying if you are wearing the right amount of clothing. In the end I would advise you to talk to your therapist so that (s)he has the opportunity to provide your best session.
Every person deserves to have access to therapeutic touch. This means that providers must come to the table with compassion for everyone who walks into our practices. We must remember that it takes a great deal of trust to lie down on a table and surrender to the therapy we have the privilege to provide. We are honored that people come to us and trust us. The mere act of walking through the door and asking for help can take a great amount of courage and we always need to understand this. With this understanding we must leave all judgments at the door.
Don Devine LMT GA # MT012315
When I started working as a Massage Therapist in 1999, I was very focused on doing the deep work. I had been instructed in very powerful techniques to increase my depth of pressure so that I could really “get in there” and break up those knots. I was most influenced by the teachers at my school who had studied Structural Integration as developed by Dr Ida Rolf. I even had the privilege to work with a man who taught with the good doctor. He really helped me hone my skills through coaching as well as, at times, demonstrating various approaches on me. Boy were those “intense.” We learned to use the word “intense” instead of painful – it just sounds better. If someone did slip up and use the term “painful,” we would quickly inform him or her that the work we are doing isn’t painful, the body we are working on is pain full and we are working to make it “pain empty.” It seemed to work in many cases. I was excited as I would dig into tissue that was bound and full of pain. The pressure that I was using created so much heat that the theory was it melted the connective tissue and then allowed that tissue to reform at a greater length, relieving pain and restoring mobility. This was big magic to me and I really loved watching the bodies change shape from the touch of my hand.
The deep work that I was doing had its drawbacks though. As I moved into the spa world, I had a lot of people come to me asking for deep tissue. At first, I was more than happy to oblige them without question. Client after client, year after year though, it wore on me. I wasn’t physically bothered by doing the deep work, I can still work just as deeply in 2019 as I could in 1999. What started to wear on me was what I observed in the people asking for the deep work. The words used to describe the pressure they wanted such as, “I can take a lot of pressure,” or “you can’t hurt me,” became difficult to hear. As a young therapist, these sounded like challenges to be met. But as the years went on, I heard the desperation of “Help me I don’t care what I have to endure in order to feel better.” I would also notice people tensing up their bodies, or holding their breath just so they could handle the pressure they thought would help. This is what has worn on me for many years now. I am a results-driven therapist. Often I find myself erring on the deeper side of pressure, but lighter touch is a key used to release the client’s guarding against pain (real or perceived). I also do not want to do any harm. How do I reconcile those things while providing top notch service? How do you convince someone who has been receiving deep pressure, with no lasting result, for her entire adult life to try something different?
My answer is this: We have to take ego out of the equation. Who’s ego? EVERYBODY’s ego. No more “You can’t hurt me” and the inevitable “Oh, yes I can.” We have to acknowledge that bodywork is a dance with two partners who are working together to improve quality of life. We must realize that allowing the body to open up and release tension is a viable option. After all, I really don’t want to hurt people. I am here to do the exact opposite. But I have to admit that it even took me more years than it should have to be able to wrap my head around the idea that lighter presser could work. I had to realize that the body is at times like a toddler or a teenager. You can use a lot of pressure (like yelling at them) and you may get the results you want, but you will often get a good deal of resistance. If you are able to talk to the body (or the toddler/teenager) in an inviting tone, with gentleness, you may get resistance but it is usually much less and you may even achieve compliance more quickly. There is a moment for each approach and knowing when to use which is essential.
How can we tell if lighter pressure is more appropriate than deep work? First off, there is a list of health conditions that your therapist should know that are contraindicated (meaning it should not be used) for deep tissue. I won’t go into the whole list here, that is for us to go through individually at the time of your appointment. I will, however tell you this, contrary to common belief, if you have a stress-related condition, deep pressure is probably not a good idea.
Deep tissue massage is often seen as a stress reliever though right? I know, we hear that all the time, but the truth of the matter is, when we are under stress our fight or flight instinct is triggered and we have an increase in the hormone called cortisol. Cortisol’s function is to give us the strength to fight or run away from an attacker. It is there to save our lives from an immediate danger. When this is increased, all of our energy is focused on survival. Picture if you will the starship, Enterprise, diverting all its energy to the shields or the warp drive in response to an attack, That is essentially what happens in our bodies. Our body says, “All hands on deck!” There is no energy left to heal the body while we are under the red alert of stress that triggers cortisol. This is a time for a lighter pressured massage. I am not saying you a need feather light tickling massage. Your body just needs comfort in order to cut off the fight or flight response and allow your cortisol levels to reduce. Once that has happened, your body can focus its energy on healing. This is the real big magic, triggering the healing response of the body.
We also hear the term, “sports massage” but different people think different things when they use this term. And they are right. When working with athletes, many different approaches need to be taken depending on where she or he is in the cycle of the sport. Is it pre-season, the competitive season, or post-season? Is the massage a part of rehabilitation from an injury? Is it half-time at the game, or between events at a swim or track meet? The answers to these questions help to determine what the goal and approach should be for each session. Sports massage is such a broad category of massage that it is a specialty all to itself. Perhaps another time I will write about that.
Finally, we can talk about Swedish massage. This term is often used to describe a light pressure massage that is nonspecific in nature. It is often seen as one of those massages that is pure luxury with no real benefit other than relaxation. But if you remember what we already covered regarding cortisol you know that “only relaxation” means that the healing process has been triggered so it can be just as beneficial as deep tissue or sports massage.
In the end, the best way to determine what kind of pressure you need is to talk it over with your therapist. Tell him or her about your health condition and your goal for the session. Open communication and trust are the keys to a potentially profound session. Finally, pressure in a massage is purely subjective. Feathering light for one person can be too deep for another person, but if you are fighting against what your therapist is doing by clenching your muscles, or holding your breath, the work is deeper than it needs to be. The more information you provide for your therapist the better (s)he can help you reach your goals.
Blessings to you
-Don Devine LMT, GA #MT012315
Devine Hands, divine massage!
For more information:
email Devinehandsbodywork@gmail.com or call/text 912-541-0589